Your systems are running. Someone's handling tickets, managing backups, dealing with vendors. But you're still not sure if your technology actually supports your mission or just exists.
The question isn't whether you need IT support. You already have that. The question is whether you need technology leadership, and if so, what kind.
A full-time chief technology officer makes sense when your organization has reached a specific threshold of complexity and investment.
Consider this option when:
The investment is substantial: full compensation, benefits, and the organizational integration that makes the role effective. You're paying for someone who can make real-time decisions and be present across all strategic initiatives.
When the complexity and strategic importance justify the investment, dedicated technology leadership changes how effectively your organization can grow and adapt.
Fractional technology leadership addresses a specific gap: you need strategic guidance, but you don't have enough work to justify a full-time executive hire.
This approach makes sense when:
Fractional engagement means you're paying for judgment and experience, not hours. Your existing IT staff continues to manage day-to-day operations. The fractional CTO helps you determine what's worth doing and why.
This model works best when your primary questions are "what should we prioritize?" and "is this investment justified?" rather than "who's going to implement this?"
Most community health centers work with some combination of managed service providers, value-added resellers, and implementation consultants. These relationships handle important functions:
Many of these vendors provide honest, consultative guidance and genuinely prioritize client success. The limitation isn't integrity. It's incentive structure.
MSPs generate revenue through recurring service contracts. VARs earn commissions on software sales. Implementation consultants bill by the hour for project work. Even the best vendors are optimizing within the scope of services they provide. They're less likely to recommend reducing complexity, cutting services, or questioning whether you need what they're currently managing.
Vendors excel at execution. When you know what needs to be done, they're essential for getting it implemented. They're less equipped to provide the unbiased perspective that helps you determine what's worth doing in the first place.
Full-time CTOs are invested in your organization's long-term success and accountable to your leadership team. Fractional CTOs provide strategic judgment without the conflicts inherent in vendor relationships. Traditional vendors deliver execution capability but operate with structural incentives that may not align with your best interests.
Most organizations need all three at different times:
The common mistake is expecting your MSP to function as your strategist, or assuming your technical staff member can also serve as your CTO. These require different skills, different perspectives, and deliver different value.
Consider these questions:
If you're confident in your answers, your current structure is likely appropriate. If these questions create uncertainty, or if technology decisions feel more like guesswork than informed choice, you may lack the strategic leadership your organization needs.
The 7-Metric Assessment provides a structured way to evaluate where you currently stand. It won't prescribe whether you need a full-time CTO or fractional support, but it will reveal whether your current approach is delivering the results your organization requires.
That clarity matters before making decisions that affect both your budget and your team's capacity to serve your community effectively.
The free assessment is available at assessment.metric7.net or reach out if you'd like to discuss your specific situation.